To the Editor

I have found virtually all the printed checklists* that I have ever seen for pre-anesthetic machine checkouts to be needlessly lengthy and burdensome. The best checkout routine I ever heard was a mnemonic taught to me before I began my residency.

The mnemonic is as follows: TV LAD IS BEST

T tanks

V vaporizers, ventilator

L leaks (includes connection of ETCO2 monitoring line)

A airway

D drugs

I IV

S suction

B blood pressure (cuff)

E EKG

S stethoscopes (esophageal, precordial)

T temperature

The only new item I add is a fifth monitoring device, the pulse oximeter.

To this day, I go through the mnemonic and set up my machine and supplies in the same order before every anesthetic I administer and it has not failed me yet. As far as I can tell it covers in simple fashion all the items of the more elaborate printed checklists.

Leo I. Stemp, M.D. Atlanta, GA

* Anesthesia Patient Safety Foundation Newsletter. Checklists cited as contributing to safety. 5:30-31, Fall 1990